We present a case of an 18-year-old male athlete who presented with complaints of right lower leg pain for 10 days following intense exercise. The most likely diagnosis was a possible tibial stress fracture or a ''shin splint'' syndrome. The radiograph did not reveal any significant abnormality in the form of any fracture or a cortical break. We performed planar bone scintigraphy including single-photon emission computed tomography (CT)/CT that revealed the presence of the two concomitant pathologies in the form of a hot spot which corresponded with a bone lesion in the tibial stress fracture and subtle remodeling activity without evidence of significant cortical lesion in the shin splints in bilateral lower limbs (R>L).
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